Please provide the names and email addresses of the people who have helped you in your fundraising efforts.

This is a required question

Medical Information

All medical information will be compiled by the DanceBlue medical staff and used in case of an emergency.

Which of the following, if any, describes you?
*

Vegetarian

Vegan

Lactose Intolerant

None

Other:

This is a required question

List any known food allergies.
*

This is a required question

List any known medical conditions.
*

This is a required question

List all medications you may be taking during the 24-hour marathon.
*

This includes any known prescriptions and birth control.

This is a required question

Have you had any surgeries in the last 12 months?
*

This is a required question

If yes, please describe the procedure.

This is a required question

Indicate your preference for pain medication.
*

Tylenol

Ibuprofen

This is a required question

List any other information that may be helpful for EMS or the DanceBlue staff.

This can include special needs, marathon needs, disabilities, etc.

This is a required question

Medical Agreement
*

I agree that my medical information may be shared with the DanceBlue Medical Staff.

This is a required question

Emergency Contact Information

Indicate two family members to contact in case of an emergency.

Emergency Contact #1 Name
*

This is a required question

Emergency Contact #1 Phone Number
*

This is a required question

Emergency Contact #2 Name
*

This is a required question

Emergency Contact #2 Phone Number
*

This is a required question

DanceBlue Dancer Agreement

In consideration of the University of Kentucky granting me permission to participate in DanceBlue 2013, I declare myself physical sound and suffering from no condition, impairment, disease or infirmity, or other illness that would prevent my participation. I acknowledge that I have either had a physical examination and have been given a physicians’ permission to participate, or that I have decided to participate in this activity without the approval of my physician and do hereby assume all responsibility for my participation in this activity including risks of property loss and personal injury, including death.
I do hereby release the Commonwealth of Kentucky, and their employees and agents from any and all liability as a result of my participation, unless such liability is a direct result of the University of Kentucky's negligent acts or omissions. I understand and appreciate the inherent risk of participating in DanceBlue. I know that these risks include but are not limited to, exhaustion, physical injury, and loss or damage of personal property.
I fully assume the inherent risks associated with DanceBlue and assert that I am voluntarily participating. The University of Kentucky reserves the right to require that I withdraw at any time when in the sole judgment of University officials, it is not physically safe to continue participating. I agree to assume any and all costs of any required medical treatment. I understand that by checking below, I have read this release of liability, fully understand it, freely and voluntarily sign it, and I am acting for myself, my heirs, personal representatives and assigns in doing so.

Do you agree to all of the above?
*

I agree

This is a required question

Dancer's Responsibility Agreement

I agree to pay the $35 dancer registration fee via check or cash at the UK Student Center ticket office by Wednesday, February 7th at 4:00 PM. I acknowledge that this fee is non-refundable. Additionally, I agree to attend one of the mandatory dancer information meetings on Tuesday, February 12th at 5:30 PM or 7:30 PM located in Worsham Theatre in the Student Center. If I am unable to attend I will notify Tyler Fields at registration@danceblue.org to attend a makeup meeting - time and date to be announced.

Do you agree to all of the above?
*

I agree

This is a required question

Please indicate which of the following dancer information meetings you plan on attending
*

Tuesday, February 12th at 5:30 PM at Worsham Theatre in the Student Center

Tuesday, February 12th at 7:30 PM at Worsham Theatre in the Student Center

I cannot attend either of the meeting times listed above. I will attend a makeup meeting - time and date to be announced.

This is a required question

Media Agreement

I hereby grant permission to the University of Kentucky and its affiliates and subsidiaries, including but not limited to the UK Alumni Association, and UK Research Foundation, to interview, photograph, and/or videotape me; and/or to supervise any others who may do the interview, photography, and/or videotaping; and/or to use and/or permit others to use information from the aforementioned interview and/or the aforementioned images in educational and promotional activites for UK Educational Publications/Videos, UK Electronics Publishing (e.g. World Wide Web), UK Promotion/Advertising, and Local/Regional/National News Media (w/ permission of UK) without compensation.